188 articles - From Friday Nov 15 2024 to Friday Nov 22 2024
Guidelines and related publications, position statements, white papers, technical reviews, consensus statements, etc…
| Gastroenterology |
|---|
AGA Clinical Practice Update on Endoscopic Enteral Access: Commentary. Description The purpose of this American Gastroenterological Association (AGA) Clinical Practice Update is to facilitate understanding and improve the clinical practice of endoscopic enteral access. Methods This expert commentary was commissioned and approved by the AGA Institute Clinical Practice Updates Committee and the AGA Governing Board to provide timely guidance on a topic of high clinical importance to the AGA membership, and underwent internal peer review by the Clinical Practice Updates Committee and external peer review through standard procedures of Gastroenterology. |
AGA Clinical Practice Update on Nonampullary Duodenal Lesions: Expert Review. Although usually diminutive, recurrence is often scarred and not amenable to conventional snare resection and may require avulsion techniques to achieve cure. BEST PRACTICE ADVICE 13: Nonampullary duodenal adenomas associated with familial adenomatous polyposis should be considered for endoscopic resection based on size (≥1 cm), morphologic characteristics, advanced histology (ie, high-grade dysplasia), and/or based on Spiegelman criteria. |
| Gastrointest Endosc |
American Society for Gastrointestinal Endoscopy guideline on gastrostomy feeding tubes: summary and recommendations. The ASGE suggests that the periprocedural management of anticoagulants should be based on a multidisciplinary discussion regarding the risk of bleeding versus cardiovascular events. In patients with malignant dysphagia, either transoral "pull" PEG or direct PEG can be performed for initial enteral access. |
Interobserver Agreement in Dysplasia Grading of Intraductal Papillary Mucinous Neoplasms: Performance of Kyoto Guidelines and Optimization of Endomicroscopy Biomarkers through Pathology Reclassification. Despite substantial IOA among experienced PB-pathologists, a second pathologist's review may be warranted for dysplasia classification in IPMNs under certain circumstances. Incorporating an imaging biomarker such as EUS-nCLE with Kyoto-HRS improves sensitivity for HGD-IC without sacrificing accuracy. |
Validation of British Society of Gastroenterology guidelines for acute lower gastrointestinal bleeding from 8,956 cases in Japan. The BSG guidelines suggest a management approach that can clearly differentiate severity. However, caution is advised when using the Oakland score to triage patients for outpatient follow-up. Additionally, prompt intervention may be necessary for groups not covered by the guidelines. |
meta-analyses and systematic reviews
| Aliment Pharmacol Ther |
|---|
Management of Muscle Cramps in Patients With Cirrhosis: A Systematic Review of Randomised Controlled Trials. Methocarbamol, orphenadrine, and taurine supplementation were found in placebo-controlled RCTs to be effective in reducing cramp frequency, severity, and duration in cirrhotic patients. All other interventions reported aside from electro-acupuncture demonstrated a positive impact on cramps. High-quality RCTs are needed to further investigate the use of these treatments in terms of comparative efficacy and safety. |
Meta-Analysis: Evaluating Placebo Rates Across Outcomes in Eosinophilic Oesophagitis Randomised Controlled Trials. Over 40% of patients in eosinophilic oesophagitis trials respond clinically to placebo, and this is associated with trial design factors such as randomisation ratio and trial population. Objective endoscopic and histologic measures are associated with very low placebo responses. |
Meta-Analysis: Prevalence of Frailty and Associated Adverse Events in Inflammatory Bowel Diseases. Frailty is common in patients with IBD and is associated with IBD-related adverse outcomes including infection-related admissions following treatment, post-operative morbidity and death. Future work should focus on developing risk assessment tools to better support decision making for older people with frailty and IBD. |
| Am J Gastroenterol |
Family History of Colorectal Cancer and the Risk of Colorectal Neoplasia: A Systematic Review and Meta-Analysis. Family history of CRC is associated with increased risk of adenoma, NAA, AA, and AN totally, and in al available subgroups. The findings further strengthen the necessity and importance of an intensified screening strategy for individuals with a positive family history of CRC, which is very useful for related health resource allocation and policymaking. |
| Gastroenterology |
Adverse Events Associated with Endoscopic Retrograde Cholangiopancreatography: Systematic Review and Meta-analysis. ERCP-associated AEs remain common. Incidence of post-ERCP pancreatitis remained static despite improvements in techniques, prevention, and recognition. These results are important to patients, endoscopists, and policy makers to inform consent and to encourage implementation of available risk mitigation strategies. |
RCT, clinical trials, retrospective studies, etc…
| Aliment Pharmacol Ther |
|---|
Cholate Shunt, Oral Cholate Challenge and Endoscopic Lesions of Portal Hypertension: The SHUNT-V Study. HepQuant DSI predicts the likelihood of LEV and significant PH lesions across a spectrum of patient characteristics and disease aetiologies. DSI, based on liver function and portal-systemic shunting, can aid in the decision to defer endoscopy for varices in patients with Child-Pugh A cirrhosis. |
Development and Validation of a PIVKA-II-Based Model for HCC Risk Stratification in Patients With HCV-Related Cirrhosis Successfully Treated With DAA. Our PIVKA-II-based model showed satisfactory accuracy for HCC risk stratification and may represent a valuable tool for implementing risk-based surveillance protocols in patients with HCV-related cirrhosis with SVR to DAA. |
Favourable Prognosis of Patients With Untreated HBeAg-Negative Chronic Hepatitis B Virus Infection With HBsAg < 100 IU/mL. Background Serum hepatitis B surface antigen (HBsAg) 10 IU/mL and detectable HBV DNA were associated with a higher risk of transition to the indeterminate phase. |
Real-Time Assessment of H. pylori Infection to Guide Molecular Antibiotic Resistance Testing: A Combined Endoscopy-Gastric Juice Analysis Approach. The novel method combining endoscopy with immediate intraprocedural gastric juice analysis for the detection of H. pylori, followed by AST in case of a positive finding, is valid and practical for tailoring eradication regimens for H. pylori infection. Genotypic AST from gastric aspirates is highly accurate for detecting clarithromycin and levofloxacin resistances. |
Subcutaneous Infliximab Concentration Thresholds for Mucosal and Transmural Healing in Patients With Crohn's Disease. Background Predose trough concentrations (C was positively associated with MH (≥ 18 μg/mL) and TH (≥ 30 μg/mL) in patients with CD, which may guide treatment decisions to optimise therapeutic response in the era of treat-to-target. |
| Am J Gastroenterol |
Comparison of the Bristol Stool Scale and modified version for children: Use by providers vs children: BSFS vs mBSFS-C. 1) The mBSFS-C showed greater modal agreement among both providers and children compared to the BSFS; 2) Provider-child concordance was greater with the mBSFS-C than with the BSFS. Validation in other regions/populations is needed. |
Disparities, Trends, and Predictions to 2040 in Gastrointestinal Cancer Incidence, Mortality in the USA. Despite varied trends over the past two decades, an overall increase in gastrointestinal cancer incidence and mortality rates is anticipated in the next 20 years in the U.S., underscoring the need for effective prevention and intervention strategies. |
Older Adults with Celiac Disease Are At Increased Risk of Frailty:A Nationwide Cohort Study. Older adults with CeD were significantly more likely to become frail than matched comparators. This analysis reveals the increased vulnerability that older patients with CeD are likely to experience. |
Optical Diagnosis in the Era or Artificial Intelligence. The potential benefits of AI-based resect-and-discard are many, with very little potential harm. Real world implementation studies are therefore required to pave the way for the acceptability of such strategies in routine practice. |
Preliminary results from a multicenter, randomized trial using fecal microbial transplantation to induce remission in patients with mild to moderate Crohn's disease. FMT was not effective at inducing clinical and endoscopic remission in CD using the FMT regimen in this study. Future studies may use other strategies to enhance treatment response, including longer intervention, antibiotic pretreatment, optimized donor-recipient pairing, and concomitant anti-inflammatory diet, biologic or small molecule therapies. |
| Clin Gastroenterol Hepatol |
A predictive model based on quantitative fecal immunochemical test can stratify the risk of CRC in an organized screening program. We derived and validated a predictive model for risk stratification of patients with positive FIT in a large CRC screening cohort. Applying our model in screening practice would allow policy makers to effectively prioritize FIT+ individuals based on the risk of CRC, allowing to substantially reduce the rate of delayed CRC diagnosis. |
Identification of Candidates for MASLD Treatment with Indeterminate Vibration-Controlled Transient Elastography. To identify candidates for MASLD treatment among indeterminate VCTE, an algorithm-based on the sequential combination of LSM and CAP thresholds can optimize the diagnosis of moderate-to-advanced fibrosis. |
Influence of comorbidities on health-related quality of life in alcohol-related liver disease: a population-based survey. Common comorbidities including COPD, musculoskeletal and psychiatric disease are associated with low HRQoL in ALD, independently of liver disease severity, and so are alcohol consumption and smoking. These findings highlight the importance of multidisciplinary management of patients with ALD. |
Older age but not comorbidity is associated with worse survival in patients with hepatocellular carcinoma. Older age but not comorbidity burden is associated with worse survival in patients with early-stage HCC. Further studies are needed to define the role of comorbidity in HCC prognostication. |
Prognostic Communication, Symptom Burden, Psychological Distress, and Quality of Life Among Patients with Decompensated Cirrhosis. While most patients with DC highly valued prognostic communication, the majority reported never discussing their end-of-life care preferences with their hepatologists. Self-reported terminally ill health status and inadequate prognostic communication were associated with poorer symptoms, mood, and HRQOL. Interventions to improve prognostic communication while simultaneously providing adequate supportive care are warranted. |
| Endosc Int Open |
Analysis of painful situations during unsedated esophagogastroduodenoscopy. Further research and interventions focusing on pain reduction during endoscopic procedures are warranted. The results of this study will help endoscopists manage painful situations and potentially improve skills. |
Complete extraction of main pancreatic duct residual and microstones using an 8-wire basket catheter. The 8-wire basket resulted in successful MPD residual/microstone extraction and pancreatic symptom improvement. This method may prevent symptom recurrence caused by incomplete residual/microstone clearance. |
Costs and benefits of a formal quality framework for colonoscopy: Economic evaluation. This large cohort study demonstrated that a formal gastroenterologist-led quality assurance framework embedded into the routine operations of a clinical department not only reduces interval cancers but is also cost-effective regarding life years gained and quality-adjusted life years. |
Defining standards for fluoroscopy in gastrointestinal endoscopy using Delphi methodology. This study presents consensus-based statements for safe and effective use of fluoroscopy in gastrointestinal endoscopy, addressing the well-being of healthcare workers and patients. These consensus-based statements aim to mitigate risks associated with radiation exposure while maintaining benefits of fluoroscopy, ultimately promoting a culture of safety in healthcare settings. |
Differences in regions of interest to identify deeply invasive colorectal cancers: Computer-aided diagnosis vs expert endoscopists. IoU was larger in correctly diagnosed T1b colorectal cancers. Optimal annotation of the ROI may be the key to improving diagnostic sensitivity of CAD for T1b colorectal cancers. |
Discharging the duty of candor following delayed post-endoscopy cancer diagnosis. Patient expectations need to be clarified, as do supportive structures for individual endoscopists who will be involved in DoC processes when significant lesions have been missed. Further consensus around DoC is required so that clear guidance can be given to endoscopy units. |
Dye-based chromoendoscopy detects more neoplasia than white light endoscopy in patients with primary sclerosing cholangitis and IBD. Chromoendoscopy is associated with a higher detection rate for neoplasia in patients with primary sclerosing cholangitis and IBD even with high-definition colonoscopes. |
Endoscopic characteristics to differentiate SSLs and microvesicular hyperplastic polyps from goblet cell-rich hyperplastic polyps. SSLs and MVHPs have endoscopic appearances that differ from those of GCHPs. Considering MVHPs and GCHPs as distinct entities may aid in endoscopic diagnosis of SPs. |
Endoscopic features of rectal mucosal prolapse syndrome (RMPS): Differentiation from malignant rectal tumor. Age, clinical course, and size of the lesion can be applied to distinguish MRT and RMPS. Five phenotypes have been identified and features of ulcers/protrusions should be further explored. |
Endoscopic ultrasound-guided tissue acquisition for focal liver lesions can be safely performed in patients with ascites. In focal liver lesions with ascites, EUS-TA allows biopsy without the intervention of ascites in most cases. The incidence of AEs did not differ significantly between patients with and without ascites. |
Enhancing physician support in pancreatic cancer diagnosis: New M-F-RCNN artificial intelligence model using endoscopic ultrasound. The M-F-RCNN model shows exceptional performance in diagnosing pancreatic cancer via EUS images, greatly improving diagnostic accuracy and efficiency, thus enhancing physician proficiency and reducing diagnostic errors. |
Non-neoplastic findings in colon capsule endoscopy: Additional yield. Furthermore, NNFs may develop into clinically significant conditions despite their benign appearance. This paper expands on the limited literature about prevalence of NNFs and underscores the additional value of CCE video recordings beyond detecting polyps. |
Online patient endoscopy education platform improves outpatient bowel preparation quality: Retrospective observational study. Our study supports the addition of a novel patient-oriented online educational video resource as an effective tool in enhancing bowel preparation adequacy while maintaining provision of high-quality colonoscopy. |
| Endoscopy |
Fast-tracking ERCP learning with the Boškoski-Costamagna Trainer: results of a multicenter randomized clinical trial. Early simulation training with the BCT improved technical competence in native biliary cannulation and accelerated overall ERCP learning. This approach has the potential to enhance ERCP training programs. |
Procedural outcomes of a novel underwater injection endoscopic mucosal resection technique for colorectal polyps ≥10 mm (with video). UI-EMR safely demonstrated high success rates for en bloc resection, and potentially ensures sufficient VM. This technique might become an option, particularly for relatively small lesions concerning for T1-CRC and deserve further study. |
Virtual scale endoscope vs snares for size measurement accuracy of smaller colorectal polyps: A randomized controlled trial. Using VSE improves polyp size measurement accuracy during colonoscopy in comparison with snare-based size estimation. In clinical scenarios, VSE reduced misclassifications at clinically relevant size thresholds 2,3 and 5mm which is relevant for adequate choice of polypectomy techniques or when implementing resect and discard strategies. |
| Gastroenterology |
CREEPING FAT-DERIVED FREE FATTY ACIDS INDUCE HYPERPLASIA OF INTESTINAL MUSCULARIS PROPRIA MUSCLE CELLS - A NOVEL LINK BETWEEN FAT AND INTESTINAL STRICTURE FORMATION IN CROHN'S DISEASE. Creeping fat released long-chain FFA induce a selective proliferative response by HIMC. These results point to creeping fat as a novel contributor to stricture formation in CD. |
Hypoxic and acidic tumor microenvironment-driven AVL9 promotes chemoresistance of pancreatic ductal adenocarcinoma via the AVL9-IκBα-SKP1 complex. AVL9 expression is driven by HIF1α in PDAC. The physical interaction of AVL9, IκBα, and SKP1 provides a novel molecular mechanism for the abnormal activation of the NF-κB pathway. Therefore, the AVL9-targeting drug Edotecarin could be a promising therapeutic strategy for sensitizing PDAC to AG. |
| Gastrointest Endosc |
Clinical Management of Patients with Colorectal Intramucosal Carcinoma Compared to High-Grade Dysplasia and T1 Colorectal Cancer. Patients diagnosed with colorectal IMC were more likely to undergo surgery after complete endoscopic resection than when HGD was diagnosed, although they were not at increased risk of SAN or MAN in this study and the known risk of nodal metastasis with colorectal IMC is small (0-2%). Unless a patient diagnosed with IMC is particularly concerned with this small risk, complete endoscopic resection should be considered definitive treatment for IMC and should not be followed by surgery. |
Closure of gastric mucosal defects using the reopenable-clip over the line method to decrease the risk of bleeding after endoscopic submucosal dissection: a multicenter propensity score-matched case-control study (with video). ROLM is feasible for mucosal defect closure following gastric ESD and effectively prevents post-ESD bleeding in high-risk patients, addressing a significant gap in existing methods. |
Digital single-operator cholangioscopy for difficult anastomotic biliary strictures in living donor liver transplantation recipients after failure of standard ERCP: SPYPASS-2 study. This study shows the efficacy and safety of SOC-facilitated management for difficult ABS in LDLT patients after failure of standard ERCP. |
Endoscopic Background Mucosal Resurfacing to Prevent Metachronous Recurrence of Superficial Esophageal Squamous Cancer After Curative Endoscopic Submucosal Dissection: A Randomized Pilot Study With 5-Year Follow-Up (with video). In this randomized trial of patients with multiple small LVLs over the esophageal background after curative ESD, EBMR with balloon-type RFA is a promising and safe procedure for preventing metachronous recurrence over 5 years of follow-up. Clinical trial registration |
Identification of risk factors associated with post-ERCP pancreatitis in patients with easy cannulation: A prospective multicenter observational study. Our findings underscore the importance of assessing patient- and procedure-related factors to mitigate the risk of PEP in patients undergoing easy cannulation. Despite the low incidence of PEP, the potential for the occurrence of severe cases emphasizes the need for cautious intervention, particularly in patients with a history of acute pancreatitis and acute cholangitis upon admission. |
Repeat Peroral Endoscopic Myotomy: Technical Difficulty and Risk Factors. Re-POEM appears safe and feasible as a salvage option after initial POEM failure, with comparable procedure duration, incidence of AEs and technical difficulty to naïve POEM. Mucosal edema and submucosal fibrosis were associated with difficult Re-POEM. |
Usefulness of a dedicated laser-cut metal stent with an anchoring hook and thin delivery system for endoscopic ultrasound-guided hepaticogastrostomy in malignant biliary obstruction: a prospective multicenter trial (with video). EUS-HGS using the Hook stent demonstrated a high clinical success rate, a low rate of early AEs, and an acceptable stent patency. The Hook stent is safe and feasible for use in patients undergoing EUS-HGS. |
| Gut |
CAF-macrophage crosstalk in tumour microenvironments governs the response to immune checkpoint blockade in gastric cancer peritoneal metastases. Our findings provide a new molecular portrait of cell compositions associated with ICB resistance in patients with GCPM and aid in the prioritisation of therapeutic candidates to potentiate immunotherapy. |
Divergent lineage trajectories and genetic landscapes in human gastric intestinal metaplasia organoids associated with early neoplastic progression. Overall, our IMO biobank captured the heterogeneous nature of IM, revealing mechanistic insights on IM pathogenesis and progression, offering an ideal platform for studying early gastric neoplastic transformation and chemoprevention. |
Identifying colorectal cancer-specific vulnerabilities in the Wnt-driven long non-coding transcriptome. We propose that cancer-specific Wnt-regulated lncRNAs provide novel therapeutic opportunities to interfere with the Wnt pathway, which has so far defied effective pharmacological inhibition. |
Liquid biopsy to identify Barrett's oesophagus, dysplasia and oesophageal adenocarcinoma: the <i>EMERALD</i> multicentre study. Using a comprehensive approach integrating unbiased genome-wide biomarker discovery and several independent experimental validations, we have developed and validated a novel blood test that might complement screening options for BE/EAC. |
| Hepatology |
Oral LPCN 1148 improves sarcopenia and hepatic encephalopathy in male patients with cirrhosis: A randomized, placebo-controlled phase 2 trial. LPCN 1148 treatment improved sarcopenia and reduced the number of overt HE episodes in men with cirrhosis and sarcopenia awaiting liver transplant. These findings support additional research on the efficacy of LPCN 1148 in treating sarcopenia and preventing HE recurrence. |
| J Hepatol |
Circulating tumor DNA status and dynamics predict recurrence in patients with resected extrahepatic cholangiocarcinoma. In patients with resected eCCA, ctDNA status and dynamics predicted recurrence during adjuvant therapy, and may help optimize clinical decision-making. Impact and implications The findings from this study highlight the critical role of ctDNA as a prognostic biomarker and monitoring tool for patients with resected extrahepatic cholangiocarcinoma (eCCA). By demonstrating the superiority of ctDNA to predict disease recurrence compared to conventional biomarkers such as CA 19-9 and CEA, this study underscores its potential in guiding decision-making during adjuvant chemotherapy. These results may be crucial to refine post-surgical treatment strategies and improve patient outcomes. The practical application of ctDNA monitoring could lead to more personalized treatment approaches, enabling timely interventions based on minimal residual disease (MRD) status. Clinical trial registration |
Genetic study of intrahepatic cholestasis of pregnancy in Chinese women unveils East Asian etiology linked to historic HBV epidemic. We uncovered a distinct genetic etiology of ICP in East Asians, likely linked to a historic HBV epidemic in East and Southeast Asia within the last 3,000 years. These findings enhance our understanding of ICP pathophysiology and offer potential for more precise detection, assessment, and treatment of the disorder. Impact and implications This study provides novel insights into the genetic basis of intrahepatic cholestasis of pregnancy (ICP) in East Asian populations, where little was previously known. The identification of the East-Asian-specific 14q24.1 locus, associated with both fasting TBA and ICP, and its connection to a historical hepatitis B epidemic emphasize the importance of incorporating population-specific history into disease research. These findings are crucial for researchers studying pregnancy-related liver disorders and clinicians providing care to pregnant women, enabling more accurate screening, risk assessment, and targeted interventions for ICP. |
HBV shows different levels of adaptation to HLA class I-associated selection pressure correlating with markers of replication. HBV sequence diversity is shaped by HLA class I-associated selection pressure with the HBV core protein being a predominant target of selection. Importantly, different levels of adaptation to immune pressure were observed between HBV infection stages, which need to be considered in the context of T cell-based therapies. Impact and implications The immune response mediated by CD8 T cells plays a critical role in controlling HBV infection and shows promise for therapeutic strategies aimed at achieving a functional cure. This study demonstrates that mutational escape within CD8 T cell epitopes is common in HBV and represents a key factor in the failure of immune control. Notably, the HBV core protein emerges as the primary target of CD8 T cell selection pressure. Additionally, the observed correlation between HBV adaptation levels and viral replication markers indicates that CD8 T cell immunity may influence transitions between phases of chronic HBV infection. |
Multi-Modal Analysis of human Hepatic Stellate Cells identifies novel therapeutic targets for Metabolic Dysfunction-Associated Steatotic Liver Disease. This study identified novel gene targets and regulatory mechanisms underlying activation of MASH fibrogenic HSCs and demonstrated that genetic or pharmacological inhibition of select genes suppressed liver fibrosis. Impact and implications Here we present snRNA-seq and snATAC-seq analysis of human HSCs from NORMAL, MASL, and MASH livers. We identified additional subclusters that were not detected by previous studies and characterized the mechanism by which HSCs activate in the MASH livers, including the transcriptional machinery that activates HSCs into myofibroblasts. For the first time, we described the pathogenic role of activated HSC-derived PAI-1 (a product of SERPINE1 gene) in the development of MASH liver fibrosis. Targeting of RUNX½-SERPINE1 axis may provide a novel strategy for treatment of liver fibrosis in patients. |
PNPLA3(148M) is a gain-of-function mutation that promotes hepatic steatosis by inhibiting ATGL-mediated triglyceride hydrolysis. These findings support the premise that PNPLA3(148M) is a gain-of-function mutation that promotes hepatic steatosis by accumulating on LDs and inhibiting ATGL-mediated lipolysis in an ABHD5-dependent manner. Our results predict that reducing, rather that increasing, PNPLA3 expression will be the best strategy to treat PNPLA3(148M)-associated SLD. Impact and implications Steatotic liver disease (SLD) is a common complex disorder associated with both environmental and genetic risk factors. PNPLA3(148M) is the most impactful genetic risk factor for SLD and yet its pathogenic mechanism remains controversial. Here we provide evidence that PNPLA3(148M) promotes triglyceride (TG) accumulation by sequestering ABHD5, thus limiting its availability to activate ATGL. Although the substitution of methionine for isoleucine reduces the TG hydrolase activity of PNPLA3, the loss of enzymatic function is not directly related to the steatotic effect of the variant. It is the resulting accumulation of PNPLA3 on LDs that confers a gain-of-function by interfering with ATGL-mediated TG hydrolysis. These findings have implications for the design of potential PNPLA3(148M)-based therapies. Reducing, rather than increasing, PNPLA3 levels is predicted to reverse steatosis in susceptible individuals. |
Plenty of the editorials are available as full text through the publisher website using the provided link
| Aliment Pharmacol Ther |
|---|
Review Article: Green Management of IBD-New Paradigms for an Eco-Friendly Approach. With an inevitable increase in the number of patient visits, endoscopies, laboratory testing, and long-term therapeutic strategies for IBD, the clinical community should be aware of environmental concerns and investigate possible strategies to reduce the environmental impact of IBD care. |
| Endosc Int Open |
| Gastrointest Endosc |
| Gut |
Recent advances in clinical practice: mastering the challenge-managing IBS symptoms in IBD. Subsequent treatment should be initiated that is evidence-based and often multimodal, including classical and non-classical pharmacological agents as well as lifestyle and microbiota-based approaches, spanning the breadth of the gut, brain and its interaction. Treatment goals in this substantial part of the IBD population should be adapted to not only focus on treating the inflammation but taking care of the patient. |
| J Hepatol |
Mastering the Narrative: Precision Reporting of Risk and Outcomes in Liver Transplantation. It also limits generalizability of study findings between countries, centers, and even providers. This article critically discusses frequent challenges associated with risk and outcome assessment following major surgery with a particular focus in liver transplantation. |
misc publications eg case reports, tools of the trade, images of the month, etc…
| Am J Gastroenterol |
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| Clin Gastroenterol Hepatol |
| Endosc Int Open |
| Endoscopy |
| Gastroenterology |
| Gastrointest Endosc |
| Gut |
| Hepatology |
| J Hepatol |
Letters to the editors and authors’ replies
| Aliment Pharmacol Ther |
|---|
| Gastroenterology |
| Gastrointest Endosc |
| Gut |
| J Hepatol |